COVID-19 (peds)

See Also

COVID-19 Pages

• COVID-19 (main)
  • COVID-19: Epidemiology and Pathophysiology
  • COVID-19 (Pediatrics)
  • COVID-19 (Obstetrics)
  • COVID-19: Medication therapy
  • COVID-19: Hospital Preparedness and Planning
  • COVID-19: Resource Scarcity
  • COVID-19: Testing and Surveillance
  • COVID-19: Hospital Protocol Examples

CHILDREN

Epidemiology among Children

• 2% of cases amongst < 2 years of age (NOTE: 13% in only one major city in China)
• Mostly because of household exposures (from adults)
• Vast majority of cases in US are in adults

Symptoms in children

• Fever (50-80%), cough, congestion, rhinorrhea, sore throat
• GI in some cases (at least one case with GI sx first then respiratory symptoms after)
• 50% of peds cases with fever, 30% with cough

Disease Course

• Mostly mild (for unclear reasons) except for only 2 cases:
  • 13 month developed ARDS and ICU care
  • 3 year old needed ICU
• No deaths in children under 10 (from china so far)
• Radiographic: same as adults (bilateral, pulmonary lesions, GGO; some with unilateral).

Q&A

• Are children with underlying medical conditions (asthma, or special healthcare needs) at increased risk?
  • No data exists

Labs

• Mild CRP or AST elevations
• No consistency on WBC (mild leukocytosis, leukopenia)
• Few coinfections have been reported (with RSV, Influenza, mycoplasma).
  • Coinfection unlikely (but possible) at this time

Treatment

• Supportive care, isolation at home best unless needing hospitalisation
• Infection prevention and support!!! handwashing and PPE
• No remdesavir trials in children

Transmission in Paediatrics

• Shedding for longer than adults (up to 22 days, some up to 30 days)
• Mostly goes from adults to children (not the other way around)

HCW pediatric visits

• CDC recommends decreased face-to-face triage
• nurse -directed triage and telehealth visits